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Risk factors of allergic sensitization in preschool children with chronic cough.

Eun Seob LEE ; Ji Seok BANG ; Yeon Joung OH ; Jung Won LEE ; Tae Jung SUNG ; Yong Ju LEE ; Kon Hee LEE

Allergy, Asthma & Respiratory Disease.2015;3(2):105-108. doi:10.4168/aard.2015.3.2.105

PURPOSE: Chronic cough is one of the major symptoms of asthma and allergic sensitization and may appear prior to the onset of asthma. The object of this study was to investigate the risk of allergic sensitization in preschool children with chronic cough. METHODS: We reviewed the medical records of 99 preschool children presenting with chronic cough but not with allergic rhinitis, atopic dermatitis, recurrent wheezing, or lower respiratory tract infection between November 2011 and July 2013. RESULTS: Fifty-four children (55%) were sensitized at least one of the following inhalant allergens: Dermatophagoides pteronyssinus, Dermatophagoides farinae, cockroach, Alternaria alternata, dog dander, and cat epithelium. Children with allergic sensitization had a higher blood total IgE levels transformed by common logarithm (1.9+/-0.6 IU/mL vs. 1.3+/-0.5 IU/mL, P<0.001) and eosinophils (3.7%+/-2.5% vs. 2.7%+/-2.0%, P=0.043), more frequent parental history of allergy (68% vs. 48%, P=0.044) and less frequent history of breast milk feeding (68% vs. 86%, P=0.041) than those without. CONCLUSION: These results suggest that the ratio of allergic sensitization may be 50% or more in preschool children with chronic cough and that parental history of allergy and formula milk feeding may be associated with allergic sensitization.
Allergens ; Alternaria ; Animals ; Asthma ; Cats ; Child ; Child, Preschool* ; Cockroaches ; Cough* ; Dander ; Dermatitis, Atopic ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Dogs ; Eosinophils ; Epithelium ; Humans ; Hypersensitivity ; Immunoglobulin E ; Medical Records ; Milk ; Milk, Human ; Parents ; Respiratory Sounds ; Respiratory Tract Infections ; Rhinitis ; Risk Factors*

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Plasma secreted phospholipase A2 in asthmatic children: correlation with leptin levels and exercise induced bronchoconstriction.

Jueng Sup YOU ; Won Bok CHOI ; Yoon Young YI ; Soo In JEONG ; Joon Sup SONG ; Seong YANG ; Il Tae HWANG ; Ha Baik LEE ; Hey Sung BAEK

Allergy, Asthma & Respiratory Disease.2015;3(2):99-104. doi:10.4168/aard.2015.3.2.99

PURPOSE: Dysregulated cysteinyl leukotriene (CysLT) synthesis is prominent in exercise-induced bronchoconstriction (EIB). Secreted phospholipase A2 (sPLA2) plays a key regulatory role in the biosynthesis of CysLTs. We previously found that serum leptin levels correlate with (EIB) in children with asthma. The aim of this study was to address the relationship between plasma sPLA2/leptin levels and EIB. METHODS: Sixty-seven prepubertal children between the ages of 6 and 10 years were included in the study. They were asthmatics with EIB (n=25), asthmatics without EIB (n=21), and healthy subjects (n=21). We measured the plasma sPLA2 and leptin levels. We also performed pulmonary function tests at baseline, after bronchodilator inhalation, and after exercise. RESULTS: The sPLA2 and leptin levels were significantly higher in asthmatics with EIB than in those without and control subjects. In addition, sPLA2 levels were significantly correlated with body mass index (Speraman correlation coefficient r=0.343, P=0.023) and leptin levels (partial correlation coefficient r=318, P=0.033). The maximum decrease in % forced expiratory volume in 1 second after exercise was significantly correlated with both PLA2 levels (r=0.301, P=0.041) and leptin levels (r=0.346, P=0.018). CONCLUSION: The sPLA2 and leptin levels were significantly higher in asthmatics with EIB than in asthmatics without EIB and control subjects. In addition, sPLA2 levels were significantly correlated with leptin levels and EIB in asthmatic children.
Asthma ; Body Mass Index ; Bronchoconstriction* ; Child* ; Forced Expiratory Volume ; Humans ; Inhalation ; Leptin* ; Phospholipases A2* ; Plasma* ; Respiratory Function Tests

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Vitamin D in children with atopic dermatitis.

Hye Yung YUM

Allergy, Asthma & Respiratory Disease.2015;3(2):95-98. doi:10.4168/aard.2015.3.2.95

Atopic dermatitis (AD) is one of the most common inflammatory skin diseases, with a prevalence of up to 15%-20% in children and 2%-10% in adults. Patients with AD have genetically determined risk factors that affect the barrier function of the skin and immune responses that interact with environmental factors. Recently, there has been increasing awareness of the importance of vitamin D, a potential factor, in the development and progression of atopic diseases including AD. Furthermore, some reports suggested that vitamin D deficiency impairs epithelial integrity, leading to increased and inappropriate mucosal exposure to antigens promoting sensitization. Even though numerous studies favor strong associations of vitamin D deficiency during pregnancy and infancy with allergies, high vitamin D intake might be harmful according to conflicting results of other trials. The growing body of the literature indicates an inverse relationship between the severity of AD and vitamin D levels. Animal studies, case reports, randomized clinical trials, and birth cohort studies have suggested that vitamin D may alleviate the symptoms of AD through immune-modulation of the innate and adaptive immune system. Moreover, some studies have shown that in individuals with AD with low vitamin D level, repletion of vitamin D results in decreased severity of diseases. However, all these results have prompted the question of which time, dose, duration, or mode of application of vitamin D might be appropriate in children with AD. Further large cohort studies and clinical trials are warranted to assess the role of vitamin D in the prevention and treatment of AD in children.
Adult ; Animals ; Child* ; Cohort Studies ; Dermatitis, Atopic* ; Humans ; Hypersensitivity ; Immune System ; Parturition ; Pregnancy ; Prevalence ; Risk Factors ; Skin ; Skin Diseases ; Vitamin D Deficiency ; Vitamin D*

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Interpretation of negative results in genetic epidemiology.

Heung Woo PARK

Allergy, Asthma & Respiratory Disease.2015;3(2):93-94. doi:10.4168/aard.2015.3.2.93

No abstract available.
Molecular Epidemiology*

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ERRATUM: Author's Name Correction. The safety and efficacy of recombinant fibroblast growth factor 2 in human asthmatics: A pilot study.

Youn Seup KIM ; Yong Ho JANG ; Ji Hyun JEON ; Ji Hee SEO ; Soo Hyung KANG ; Young Koo JEE

Allergy, Asthma & Respiratory Disease.2014;2(4):314-314. doi:10.4168/aard.2014.2.4.314

The fourth author's name was misprinted.
Fibroblast Growth Factor 2* ; Humans ; Pilot Projects*

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Serotonin syndrome associated with linezolid.

Dong Sub JEON ; Young Hee NAM ; Suk Hyun KIM ; Won Jong CHOI ; Eun Bin KIM ; Hye Won LEE ; Hee Joo NAM ; Jeong Eun SONG ; Soo Keol LEE

Allergy, Asthma & Respiratory Disease.2014;2(4):310-313. doi:10.4168/aard.2014.2.4.310

Serotonin syndrome (SS) is a potentially life-threatening drug reaction characterized by mental status change, increased neuromuscular tone, and autonomic instability. Linezolid, an oxazolidinone antibacterial agent, is widely used in general hospitals; however, it interacts with some serotonin agonists and may cause SS. We report a case of SS caused by linezolid, without the concomitant use of serotonin agonist. A 72-year-old patient was admitted due to recurrent wound infection of his left ankle. He developed fever, skin rash, and renal function deterioration, and blood eosinophils and liver enzymes increased after administration of vancomycin. The antibiotic was changed to linezolid against methicillin-resistant Staphylococcus aureus. Four days later, he developed agitation, fever, increased blood pressure, and tachycardia. There were no abnormal findings in laboratory and image tests, including brain and chest computed tomography suggesting the cause of his symptoms. He had not taken any serotonin agonists, including serotonin uptake inhibitors and monoamineoxidase-inhibiting antidepressants. When administration of linezolid was stopped, his symptoms improved within 24 hours and fully recovered within 2 days without additional treatments.
Aged ; Ankle ; Antidepressive Agents ; Blood Pressure ; Brain ; Dihydroergotamine ; Eosinophils ; Exanthema ; Fever ; Hospitals, General ; Humans ; Liver ; Methicillin-Resistant Staphylococcus aureus ; Serotonin Receptor Agonists ; Serotonin Syndrome* ; Serotonin Uptake Inhibitors ; Tachycardia ; Thorax ; Vancomycin ; Wound Infection ; Linezolid

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Oral allergy syndrome caused by crown daisy and sesame leaf.

Ga Na HONG ; Mi Ae KIM ; Moon Kyung YOON ; So Hee LEE ; Hae Sim PARK

Allergy, Asthma & Respiratory Disease.2014;2(4):306-309. doi:10.4168/aard.2014.2.4.306

Oral allergy syndrome (OAS) is a subtype of food allergy composing of itching sense and edema in the oral cavity, lips, throat, pharynx, and larynx following ingestion of some fresh fruits or vegetables. Although the major pathogenic mechanism of OAS is known to be IgE-mediated response, here we experienced a case of OAS due to crown daisy (CD) and sesame leaf (SL) mediated by a non-IgE antibody mediated mechanism. A 33-year-old female visited our clinic to evaluate numbness of the tongue and gingiva after eating fresh CD and SL for 2 years. The patient had suffered from allergic rhinitis and atopic dermatitis for 20 years and took medications intermittently. There had been a history of food allergy to crab and shrimp. The serum total IgE level was elevated (404 kU/mL). The skin prick test showed strong positive reactions to tree and weed pollens, but not to CD and SL extracts. Enzyme-linked immunosorbant assay for detecting serum specific IgE to crude extracts of CD and SL showed negative results. The basophil activation test performed with crude extracts of CD or SL showed significant up-regulation of CD63-positive basophils by both CD and SL. In conclusion, we report a case of OAS due to CD and SL, not associated with pollen allergy, which is shown to be mediated by a non-IgE mediated mechanism.
Adult ; Basophils ; Complex Mixtures ; Crowns* ; Dermatitis, Atopic ; Eating ; Edema ; Female ; Food Hypersensitivity ; Fruit ; Gingiva ; Humans ; Hypersensitivity* ; Hypesthesia ; Immunoglobulin E ; Larynx ; Lip ; Mouth ; Pharynx ; Pollen ; Pruritus ; Rhinitis ; Rhinitis, Allergic, Seasonal ; Sesamum* ; Skin ; Tongue ; Up-Regulation ; Vegetables

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Penicillamine-induced toxic epidermal necrolysis in a patient with Wilson disease.

Yoon Im LEE ; Mu Yeol LEE ; Yong Tae PARK ; Chan Ho PARK ; Jun Young SUNG ; Ho Seok SEO ; Seung Won CHOI

Allergy, Asthma & Respiratory Disease.2014;2(4):302-305. doi:10.4168/aard.2014.2.4.302

Toxic epidermal necrolysis (TEN) is rare but life-threatening severe cutaneous adverse reaction, which is mostly induced by drugs. It characterized by widespread epidermal necrosis, resulting in bullae with sloughing and frequent involvement of the mucous membrane. Due to high mortality, management of patients requires prompt withdrawal of the causative drug, appropriate supportive care, and consideration of immune-modulating agents, such as intravenous immunoglobulin or corticosteroids. Wilson disease is an inherited disorder of copper transport that results in excessive accumulation of copper in the body. Copper chelation with penicillamine is an effective first line therapy in most patients. We present a 20-year-old man with Wilson disease who developed TEN following administration of penicillamine. He was successfully treated with systemic corticosteroid, intravenous immunoglobulin, and supportive management.
Adrenal Cortex Hormones ; Copper ; Hepatolenticular Degeneration* ; Humans ; Immunoglobulins ; Mortality ; Mucous Membrane ; Necrosis ; Penicillamine ; Stevens-Johnson Syndrome* ; Young Adult

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Delayed urticaria caused by lidocaine in a child.

Geun Mi PARK ; Hae Won HAN ; Jae Yeon KIM ; Keum Hee HWANG ; Eun LEE ; Song I YANG ; Young Ho JUNG ; Soo Jong HONG ; Ju Hee SEO ; Jinho YU

Allergy, Asthma & Respiratory Disease.2014;2(4):298-301. doi:10.4168/aard.2014.2.4.298

Lidocaine is a commonly used local anesthetic for dental treatment. Urticaria caused by lidocaine has seldom been reported. Generally, urticaria immediately develops after exposure to a causative agent and is considered a manifestation of IgE-mediated hypersensitivity. However, delayed urticaria caused by local anesthetics was reported to be related to cell mediated hypersenstivity. A 3-year old girl visited our allergy clinic due to delayed urticaria after local administration of lidocaine. Both skin prick and intradermal tests with lidocaine revealed negative reactions. However, the provocation test with subcutaneous injection of lidocaine showed urticaria 7 hours after test. In order to identify alternative local anesthetic for the subsequent dental procedure, we performed skin prick, intradermal and provocation tests with procaine, a local anesthetic of the other class, all of which showed negative results. Therefore, we recommended procaine as an alternative local anesthetic, and the patient was successfully treated with procaine. To the best of our knowledge, this is the first case of delayed urticaria caused by lidocaine in Korea.
Anesthetics, Local ; Child* ; Drug-Related Side Effects and Adverse Reactions ; Female ; Humans ; Hypersensitivity ; Hypersensitivity, Immediate ; Injections, Subcutaneous ; Intradermal Tests ; Korea ; Lidocaine* ; Procaine ; Skin ; Urticaria*

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Factors associated with serum vitamin D levels in children with recurrent wheezing less than 3 years old.

Eun Jeong CHOI ; Nu Ry BAG ; Jin A JUNG ; Dae Cheol KIM ; Hye Sung AHN ; Hyun Jin YUN

Allergy, Asthma & Respiratory Disease.2014;2(4):293-297. doi:10.4168/aard.2014.2.4.293

PURPOSE: We evaluated the relationship between laboratory/clinical factors and vitamin D levels in recurrent wheezers less than 3 years old. METHODS: We retrospectively analyzed clinical data and laboratory factors (25-hydroxyvitamin D, complete blood count, C-reactive protein, glutamic oxaloacetic transaminase, glutamyl purovic transaminase, alkaline phosphatase [ALP], eosinophil counts, and serum IgE IgG, IgA, IgM) of 84 children less than 3 years who had experienced wheezing episodes at least 3 times. RESULTS: Children in the normal group (1.4+/-0.9 years) were younger than those in the deficient (2.2+/-1.2 years) and insuffient (2.3+/-1.0 years) groups (P=0.010). Glutamyl purovic transaminase were higher in the normal group (24.5+/-19.4 IU/L) than in the deficient (16.0+/-4.7 IU/L) and insufficient (15.3+/-4.5 IU/L) groups (P=0.009). ALP were higher in the deficient (791.4+/-180.8 IU/L) and insufficient (770.4+/-251.2 IU/L) groups than in the normal group (631.9+/-127.0 IU/L, P=0.034). Total IgE levels were higher in the deficient group (171.9+/-212.1 kU/L) than in the normal group (43.7+/-58.3 kU/L, P<0.05), and the rate of sensitization to aeroallergens was higher in the insufficient group (36.1%) than in the normal group (10%, P<0.05). CONCLUSION: Among children with recurrent wheezing less than 3 years old, low vitamin D levels may be associated with older age, total IgE, ALP level, glutamic pyruvate transaminase level, and rate of sensitization to aeroallergens.
Alkaline Phosphatase ; Aspartate Aminotransferases ; Asthma ; Blood Cell Count ; C-Reactive Protein ; Child* ; Eosinophils ; Humans ; Immunoglobulin A ; Immunoglobulin E ; Immunoglobulin G ; Pyruvic Acid ; Respiratory Sounds* ; Retrospective Studies ; Vitamin D*

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